Today, the New York State Department of Health issued updated guidance for Resumption of Non-Essential Elective Surgeries and Non-Urgent Procedures in Hospitals, Ambulatory Surgery Centers, Office Based Surgery Practices and Diagnostic and Treatment Centers.
Key updates include:
Hospitals
Hospitals in all counties may resume non-essential elective surgeries and non-urgent procedures in both inpatient and outpatient settings. Waivers are no longer required.
Hospitals should continue to monitor metrics, however, original thresholds of ICU total bed capacity, ICU bed capacity, and COVID hospitalization rate based on the HERDS survey data will no longer be used to qualify hospitals to resume and continue to perform non-essential elective surgeries and non-urgent procedures.
There is no longer a requirement to submit information about the types and numbers of surgeries and procedures to the Department on a monthly basis however, hospitals should have a mechanism to report this information to the Department if requested in the future.
Testing
The test period may now be extended from three days to five days prior to the surgery or procedure. Test results should be received and reviewed before conducting the surgery or procedure. The only exception would be a nonscheduled emergent procedure where testing prior to surgery may not be feasible. In this case, a thorough screening and history should be taken as well as appropriate precautions. A test should be performed as soon as possible, and if positive, may result in the need for health care worker exposure protocols to be followed. Providers do not have to perform the test; it is allowable to accept a third-party test provided it is a viral molecular assay as described above and is performed by a laboratory with any required permits and approvals.
Transfers / Hospital Capacity
The intention was clarified for for ambulatory facilities to maintain ongoing confirmation of local hospital capacity (bed census, ICU census, and ventilator availability). The intention of this guidance is for ASC, OBS, and DTC providers to monitor capacity at the hospitals to which they would normally be transferring to and/or recommend patients visit post procedure, if necessary. Providers should establish their own policies for frequency of monitoring and may monitor local hospital capacity by region at the following link: https://forward.ny.gov/early-warning-monitoring-dashboard.
PPE
There has been no change to the requirement for ASCs, OBSs and DTCs to have adequate PPE and medical and surgical supplies appropriate to the number and type of procedures to be performed. Adequate PPE means that an ambulatory provider has at least a seven-day supply of PPE on hand, and the provider’s supply chain can maintain that level to support outpatient surgeries and procedures without resorting to contingency or crisis capacity strategies. To prepare for a potential future surge, providers should be working towards having immediate access to a 90-day supply of PPE.